Does Your Doctor Understand?

Doctors and patients don't communicate well, which can be a big health problem. If patients speak up, things improve.

Doctors do not understand their patients' health beliefs. This is the conclusion of a recent study that recorded and analyzed 207 visits of patients to their doctors.

Doctors get their health information from medical school and journals. Patients' health information usually comes from a blend of traditional media, the Internet and folklore. Yet, like many of us, doctors seem to expect patients' health beliefs to mirror their own. They don't.

The study points out that doctors need to do a better job of making sure that patients understand their medical condition. And patients need to speak up more about what they do and do not understand.

If there's ever to be agreement, doctors will have to do a better job of listening to their patients. And patients will need to speak up more during doctor visits.

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In the study, audio recordings were made of the visits of 207 patients to 29 doctors. After the visits, both patients and doctors completed a questionnaire about the causes, meaning, treatment and control of the patient's health condition. Doctors were also asked to anticipate the responses patients would put down on their questionnaires.

Overall, doctors poorly anticipated their patients' responses. Doctors thought patient responses would be similar to their own. This was rarely the case. But the more the patients had asked questions, expressed opinions or stated concerns during the visit, the more likely a doctor was to correctly predict a patient's responses.

This suggests that whatever information doctors provided to their patients during the visits often was not getting through. And the only time doctors were aware of this was when a patient told them so.

Individual findings mirrored many of society's typical communication problems between ethnic groups. Doctors were poorer judges of patient beliefs when patients were African-American, Hispanic or of a different race than the doctor. Specific misunderstandings were highest about African-Americans patients' desire to be a partner in the treatment of their medical condition, Hispanics patients' understanding of the meaning of their medical condition, and patient beliefs about how well their medical condition could be controlled when the patient and doctor were of different races.

The study points out that doctors need to do a better job of making sure that patients understand their medical condition. And patients need to speak up more about what they do and do not understand. How to accomplish this when doctor visits seem to get shorter all the time is a question few people seem to have a good answer to.

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Some emergency rooms require patients to correctly repeat their discharge instructions before the actual discharge can occur. Perhaps doctors could try using this system with their office patients. This would help make sure that patients at least understood what their doctor said about their condition during the visit.

An article detailing the study was published online by the Journal of General Internal Medicine July 23, 2010.